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Proponents of
euthanasia argue that when a person faces unbearable pain or
disability and the dignity in life is lost, it is only noble that the
state grants the right to have death hastened, writes Dr
R. Kumar Manbhari (85) lay still on her bed wearing a smile of eternal peace with her pulse, respiration and pain all gone and eyes wide open. ‘‘Till five minutes back she was watching TV and had a cup of tea in her hand. Suddenly she took a deep breath and became absolutely quite; probably she had a smooth ride`85. she was lucky,’’ said her husband sitting at her bed side. While the old man was informing the kith and kin on his mobile about the departure of Manbhari, I thought: "Can the benefit of such a smooth ride be extended to countless others who are languishing in hospitals with terminal ailments, burdening the already stretched healthcare system or dumped in a corner of the house in a state of total neglect, with a lot of physical and mental pain to bear? Can anybody offer the end on demand of the sufferer when the possibility of cure has extinguished?’’ Neither the law nor medical ethics requires that ‘every possible damn thing be done’ to keep a person alive, when the medical procedures and aids only add to his torture. It would also be cruel and inhumane to prolong his misery and cause a financial ruin of the family. Some proponents share the view that modern medicine keeps human beings alive for much longer than their natural longevity would permit. There comes a time when continued attempts to cure are not compassionate, wise, or medically sound. There is no point forcing people to stay alive ‘hooked up’ to machines, artificial feeding and hydration through a nasogastric tube and excretionary functions regulated by a catheter and by enemas, since the existence is vegetative. We see many elderly patients with debilitating chronic illnesses such as terminal chronic heart failure (CHF), chronic obstructive pulmonary disorder (COPD), malignancies and dementias. Many such patients need 24-hour care for several months with no prospects of cure. When the undisputed consensus of eminent medical opinion is that there is no prospect whatsoever that patient would ever make recovery from his present condition, but that there is every likelihood that he will maintain his present state of vegetative existence for a long time, provided that painful interventions, which he is now receiving were continued, what could be the objectives at that stage? Proponents of euthanasia emphasise that when a person faces unbearable pain or disability, and the dignity in his/her life is lost, it is only noble that the state grants him/her the right to choose to have death hastened. It is debatable whether ethics would dictate that the death be brought about quickly (by administering a lethal drug), rather than a prolonged torture of stopping artificial feeding and other treatment. Recently, many persons in this category have written to the President asking his permission to end their lives. Legalised euthanasia raises the potential for a situation in which families and the society could find themselves better off financially if a seriously ill or disabled person ‘chooses’ to die rather than receive long-term care. In India’s context where the health services are scarce and expensive, old-age social security is non-existent, the love and care to the ageing and ailing is missing, the end of the older family member seems to bring a sense of great relief to all concerned. Many people feel guilty for not choosing death, when it is inevitable. Financial considerations add to the concern about ‘being a burden’. However, doctors treating terminal cases are frequently too obsessed with the control of symptoms of disease and have little concern for the patient as a person. Doctors need to start talking to patients and their family about the futility of treatments that only prolong death. Until this major block is overcome, we will not be able to proceed to the next step—putting the wishes of the patient in writing in such a manner that they are legally binding on the medical profession. Euthanasia has so far
been legalised in northern Australia in 1995, the US state of Oregon
in 1998, Netherlands in 2001 and Belgium in 2002. Once legalised,
euthanasia becomes nearly impossible to control and leads inevitably
to patients being killed out of greed of his property or revenge,
without consent. Euthanasia, they say, erodes patient autonomy and
creates an atmosphere in which it is considered ‘easier to kill a
patient than to treat’. The safeguard on this account has to be
foolproof. A soldier throws himself on a grenade to save his
fellow-beings; a pedestrian leaps into the path of a truck to save a
child; fire-fighters remain in a collapsing building rather than
abandon trapped victims. These, too, are decisions to embrace death,
yet we leave them to the conscience of the persons concerned. Then why
tar all reasons for physician-assisted suicide with a common brush?
Given that we do not have the power to ameliorate every disease and
never will, why withhold from individuals the power to lessen the
duration of their own pain and also financial and emotional burdens
that dying process imposes on their loved ones? The dying are persons—not
always in need of one more investigation or operation, but a kind
word, an affectionate squeeze, a warm pep talk; in short, love. The
stage of acceptance of the end is a time when the patient comes to
terms with the prospect of death, and makes peace with it. Should not
all of us, even in health, weave this thread of the acceptance of
death into the very fabric of our life?
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